AccountId: 011433970860
ContactId: 640bee3f-ce66-46ea-bcb9-c351a77cdf12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 582299 ms
Total Talk Time (AGENT): 131081 ms
Total Talk Time (CUSTOMER): 168221 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/640bee3f-ce66-46ea-bcb9-c351a77cdf12_20250416T17:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and I am calling with who am I calling with? I'm sorry, uh, Canon Clark Physicians Corporation. I'm calling to check on, uh, status of a couple of claims for one of our patients.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Of course, [PII]. I can help you with claim status today. Do you have the policy number?
[CUSTOMER][NEUTRAL] I do. It's D as in David 476-87129.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEGATIVE] Is there a different number you can provide me? That one's not working.
[CUSTOMER][NEUTRAL] Mm hold on let me look here at the card.
[AGENT][NEUTRAL] It might say like member ID or policy cert number.
[CUSTOMER][NEUTRAL] Plos card up here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, no, that's the only.
[CUSTOMER][NEUTRAL] D as in David 476-87129.
[CUSTOMER][NEGATIVE] Perhaps they have the wrong.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Insurance in here.
[AGENT][NEUTRAL] Uh, do you have the patient's first and last name?
[CUSTOMER][NEUTRAL] Yes, it is [PII]
[AGENT][NEUTRAL] And it's [PII]
[CUSTOMER][NEUTRAL] [PII], mhm.
[AGENT][NEUTRAL] See, OK.
[AGENT][NEUTRAL] OK, it looks like I found him.
[AGENT][NEUTRAL] Uh, what's his date of birth?
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][NEUTRAL] OK, perfect. And the policy number is 254.
[AGENT][NEUTRAL] 5256.
[CUSTOMER][NEUTRAL] 254-525-6
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I'll get that updated in there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my first claim for him is [PII].
[CUSTOMER][NEUTRAL] No, I'm sorry, [PII]. I apologize.
[AGENT][NEUTRAL] No, that's fine. Just one more 2nd.
[AGENT][NEUTRAL] OK, I'm not seeing a claim for that data service.
[CUSTOMER][NEUTRAL] OK, do you have one for [PII]?
[AGENT][NEUTRAL] Let's try.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, not for that one either. Hold on. Let see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm gonna check another screen.
[AGENT][NEUTRAL] No, I'm not seeing a claim for that one either.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, can I verify the claim submission address with you? Maybe we're not sending it.
[AGENT][NEUTRAL] Yes, let me see.
[CUSTOMER][NEUTRAL] To the correct address, uh, let's see.
[CUSTOMER][NEUTRAL] Looks like we're sending to [PII].
[AGENT][NEUTRAL] No, that is not.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I think somebody but that I mean I don't put these in so it's not my fault um but anyway the office puts them in or the facility and then we go off of what they put in so that's probably why you don't have a copy that's probably why you don't have our claim.
[AGENT][NEUTRAL] OK, um,
[AGENT][POSITIVE] Oh, yes, I can give you the correct address.
[CUSTOMER][NEUTRAL] So let's start.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, we're way out.
[AGENT][NEUTRAL] Yeah, I was like, [PII].
[CUSTOMER][NEUTRAL] [PII] and this is.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] This is the insurance that they have in here. They have it. I don't have a card copy, but it's IMA incorporated.
[AGENT][NEUTRAL] So this is APL.
[CUSTOMER][NEUTRAL] APO OK, what's that stand for?
[AGENT][NEUTRAL] APL
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] But he does have a policy with us, so.
[CUSTOMER][NEUTRAL] And he's active, is that correct?
[AGENT][NEUTRAL] Sorry, what was that?
[CUSTOMER][NEUTRAL] He is active. He's eligible for coverage.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, do you have a.
[AGENT][NEUTRAL] So I wonder if
[AGENT][NEUTRAL] I wonder if that one was his primary insurance.
[CUSTOMER][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] Well,
[AGENT][NEUTRAL] I don't know. That's, that's weird.
[CUSTOMER][NEUTRAL] I don't know we've got CareSource in in here and we've got IMA.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Your guess is as good as mine. Do you have a group number for this policy?
[AGENT][NEUTRAL] See, yes, we do. It is 700.
[AGENT][NEUTRAL] 84
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, back to the drawing board and I'm gonna get that claim sent back out.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, sounds good. Yeah, then just give us a call back.
[CUSTOMER][NEUTRAL] OK, is there a call reference number for my call today?
[AGENT][NEUTRAL] Yes, ma'am. It's my first name, which is [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] My last initial is [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][POSITIVE] OK great all right [PII] I appreciate all your help thank you very much and I hope you have a good rest of your day.
[AGENT][NEUTRAL] Yeah, of course.
[AGENT][POSITIVE] Thanks for calling APL. You too.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] OK. Bye.